Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 20470 | OR |
NPI | 1164435566 |
---|---|
Provider Name | Jane Marie Birschbach |
First Address | Bend, OR 97702-3599 |
Second Address | Bend, OR 97701-3294 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 27/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
278325 | (05) | OR |
G50086 | (02) |